UEA Flashcards

1
Q

Patient walks in and has developed sore mouth and bleeding gums. She takes these medication:
􏰔 Aspirin 75mg dispersible tabs, 1 OD
􏰔 Betahistine 8mg tabs, 1 TDS
􏰔 Carbamazepine 200mg tabs, 1 BD
􏰔 Simvastatin 40mg tabs, 1 ON

Which ONE of the following is the MOST appropriate course of action?
A Refer her to the doctor as she may be suffering from carbamazepine side effects
B Sell chlorhexidine 0.5% mouthwash with additional mouth hygiene advice
C Sell Oragel® Dental Gel (benzocaine 10% w/w) with additional mouth hygiene advice
D Suggest an alternative to betahistine which can cause dry mouth leading to sore and bleeding gums
E Tell her to stop the aspirin as bleeding gums leading to soreness is a recognised a side effect of antiplatelet medications

A

refer as suffering from carbamazapine side effects

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2
Q

The doctors decide to start the patient on a broad spectrum antimicrobial drug which has activity particularly against atypical bacteria.
3. Which ONE of the following antimicrobials would be the MOST appropriate treatment for him?
A Amoxicillin
B Ciprofloxacin
C Clarithromycin
D Co-amoxiclav
E Metronidazole

A

Clarithrmycin

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3
Q

Which ONE of this patient􏰀s medications listed below is MOST likely to require temporary discontinuation in view of his Clostridium difficile infection?
A Ferrous sulphate
B Finasteride
C Ibuprofen
D Levothyroxine
E Paracetamol

A

Ferrous Sulphate

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4
Q

A 45-year old female is is undergoing chemotherapy with moderate emetogenic
potential. She has just received her first dose of CMF; Cyclophosphamide, Methotrexate, 5- Flourouracil as neoadjuvant chemotherapy prior to a mastectomy. You are asked to recommend an antiemetic for management of her acute symptoms.

Which ONE of the following agents is the MOST appropriate choice for this patient􏰀s chemotherapy-induced nausea and vomiting?
A Chlorpromazine
B Cyclizine
C Droperidol
D Metoclopramide
E Ondansetron

A

Ondansetron

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5
Q

What age is Bonjela for and why

A

16 or over

as it contains salicylate (a derivative of aspirin), which is contraindicated in children and adolescents under 16 years of age due to the risk of Reye’s syndrome

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6
Q

Which post surgery analgesic interacts with Dabigatran and why

A

Tramadol: it causes increases risk of bleeding

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7
Q

What is the preferred NSAID for managing pain in RA

A

Naproxen

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8
Q

Which ONE of the following is LEAST likely to occur as a result of hypersensitivity to aspirin?
A Angioedema
B Bronchospasm
C Haemorrhagic stroke
D Rhinitis
E Urticaria

A

Haemorrhagic stroke

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9
Q

What is the maximum dose of Simvastatin when used with Amlodipine. And why

A

10mg due to risk of rhabdomylosis

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10
Q

Which ONE of the following is MOST likely to reduce this patient􏰀s serum theophylline levels?
A Use of St J􏰈h􏰂􏰀􏰇 Wort for mild depression
B Occasional cannabis use
C Use of diazepam 2mg BD for anxiety
D An alcohol intake of double measure 40% whiskey per day
E Smoking 20 roll ups a day

A

Smoking: as it induces CYP1A2 reducing its serum conc

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11
Q

What electrolyte imbalance do Beta Agonists create

A

Hypokalaemia

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12
Q

What electrolyte imbalance does Insulin create

A

hypokalaemia

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13
Q

What electrolyte imbalance do loop diuretics create

A

hypokalaemia

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14
Q

What substnace imbalance does timolol cause

A

Hypoglycaemia
Timolol is a beta-blocker, similar to propranolol, and can have effects on blood glucose regulation.

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15
Q

What substance imbalance does alcohol cause

A

Hypoglycaemia

Alcohol can inhibit gluconeogenesis (the production of glucose in the liver), especially when consumed on an empty stomach or in moderate to high amounts.

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16
Q

What substance imbalance does propranolol cause

A

Hypoglycaemia

Propranolol, a non-selective beta-blocker, can mask the symptoms of hypoglycaemia and may also interfere with the liver’s ability to release glucose.

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17
Q

At what age is Guaifenasin, OXymetazoline, Phenylehidrine and Pseudoephedrine spray allowed?

A

6 and over

18
Q

What infection do these side effects entail; itching, frothy/ smelly/ yellow-green discharge from vagina

A

Trichomoniasis Vaginalis

19
Q

What are the symptoms of Phenelzine? (MOAi)

A

pale, sweaty, anxious, severe headache, N+V, chest pressure and shortness of breath

20
Q

How to treat severe community acquired pneumonia

A

Levofloxacin

21
Q

What is the most significant reason that staff should avoid handling crushed or broken finasteride tablets?
A Pharyngeal irritation if particles are inhaled
B Risk to the male foetus
C Risk of absorption into semen
D Risk of decreased libido
E The drug is cytotoxic

A

B Risk to the male foetus

22
Q

What is neurally mediated syncope

A

fainting due to drop in blood pressure and reduced blood flow to brain

23
Q

What would you do if a patient develops neurally mediated syncope after vaccine

A

elevate legs to allow blood back to brain

24
Q

Which ONE of the following is NOT licensed for once daily use?
A Aclidinium
B Glycopyrronium
C Indacaterol
D Tiotropium
E Umeclidinium

A

Aclidinium

25
Q

Which ONE of the medications is the MOST likely causative agent of her hyponatraemia?
A Aspirin
B Atorvastatin
C Bisoprolol
D Citalopram
E Ramipril

A

Citalopram

26
Q

What is red mans syndrome

A

flushing, itching and dyspnoea (can’t breath well)

27
Q

What drug can cause red mans syndrome and why

􏰔 Aspirin 75mg OD
􏰔 Dalteparin SC 5000 units OD
􏰔 Felodipine 5mg OD
􏰔 Gliclazide 80mg OD
􏰔 Insulin glargine 12 units nocte
􏰔 Paracetamol PO 1g QDS PRN
􏰔 Vancomycin IV 1g daily

A

vancomycin due to rapid infusion rate

28
Q

Which ONE of the following antibiotics is RARELY associated with C. difficile diarrhoea?
A Ciprofloxacin
B Clindamycin
C Co-amoxiclav
D Cefalexin
E Doxycycline

A

Doxycycline

29
Q

What vitamin imbalance does Isoniazide cause

A

Vitmain b6

30
Q

What is nicorandil used for

A

stable angina

31
Q

What happens when you take phenytoin and levonorgestrel

A

phenytoin is enzyme inducer, reducing effectiveness of contraception

32
Q

What antihypertensives cause peripheral oedema

A

Amlodipine and felodepine

33
Q

Which of these opioids have a mixed agonist and antagonist opioid receptor activity:

A Alfentanyl
B Diamorphine
C Fentanyl
D Meptazinol
E Methadone
F Morphine
G Pethidine
H Tramadol

A

Meptazinol

34
Q

When and why would you Alfentanyl instead of diamorphine in injections

A

in renal impairment, as opioids like diamorphine have active metabolites that can accumulate due to renal impairment

35
Q

what colour does doxorubicin make your urine

A

red

36
Q

What symptoms does vincristine cause

A
  • peripheral neuropathy (pins and needles),
  • constipation
  • loss of tendon reflexes
37
Q

Which medication is related with pulmonary fibrosis.

A Bleomycin
B Cyclophosphamide
C Doxorubicin
D Lomustine
E Melphalan
F Mitomycin
G Paclitaxel
H Vincristine

A

A Bleomycin

38
Q

What vitamin deficiency is caused by Wernicks Encapethlopathy

A

Vitmain B1 (Thiamine)

39
Q

What is status epilepticus

A

A seizure lasting more than 5 mins

40
Q

What is acute treatment for status epilepticus

A

rectual diazepam